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Week 1.2 Epidemiology
Week 1.2 Epidemiology
Epidemiology
LECTURE 2: EPIDEMIOLOGY
After studying this chapter, you should be able to:
• Define epidemiology and understand the common
tools used in its study
• Classify diseases according to transmissibility and
occurrence.
• Understand the concepts of chain of infection and
reservoirs of infection
Introduction
Epidemiology is the study of factors that determine the
frequency, distribution, and determinants of diseases in
human populations, and ways to prevent, control, or
eradicate diseases in populations.
Epidemiologist – are scientists who specialize in the study of
disease and injury patterns (incidence and distribution patterns)
in populations, and ways to prevent or control diseases and
injuries.
EPIDEMIOLOGY TOOLS
Basic Epidemiology Tools:
• Incidence
• Morbidity rate
• Period prevalence
• Point prevalence
• Mortality rate
• Case fatality rate
EPIDEMIOLOGY TOOLS
• Incidence – is defined as the number
of new cases of that disease in a
defined population during a specific
time period.
Example: the number of new cases
of Dengue in the Philippines in
2019.
EPIDEMIOLOGY TOOLS
• Morbidity rate – is the number of new cases of a
particular disease that occurred during a
specified time period per a specifically defined
population (usually per 1,000, 10,000, or
100,000 population).
Example: the number of new cases of a
particular disease in 2009 per 100,000 U.S.
population.
• Communicable disease – is an
infectious disease that is
transmissible from one human to
another. Example: HIV
TYPES OF DISEASES ACCORDING TO
TRANSMISSIBILITY
• Contagious disease – is a
communicable disease that is
easily transmitted from one
person to another. Example:
influenza
• Zoonotic diseases or zoonoses –
are infectious diseases that
humans acquire from animal
sources. Example: malaria
TYPES OF DISEASES ACCORDING TO
OCCURRENCE
The types of diseases according to
occurrence are:
• Sporadic disease
• Endemic diseases
• Epidemic (or outbreak)
• Pandemic
TYPES OF DISEASES ACCORDING TO
OCCURRENCE
• Sporadic disease – is a disease
that occurs only occasionally
(sporadically) within the
population of a particular
geographic area.
Example: tetanus, and typhoid
fever.
TYPES OF DISEASES ACCORDING TO
OCCURRENCE
• Endemic diseases – are diseases that are
always present within the population of a
particular geographic area. The number of
cases of the disease may fluctuate over time,
but the disease never dies out completely.
Example: tuberculosis (TB), common cold,
influenza, chickenpox, and mumps.
Chicken pox
rashes
TYPES OF DISEASES ACCORDING TO
OCCURRENCE
• Epidemic (or outbreak)
– is defined as a greater than usual
number of cases of a disease in a
particular region, usually occurring
within a relatively short period of
time.
TYPES OF DISEASES ACCORDING TO
OCCURRENCE
Some epidemics that happened abroad:
❖ Legionnaires’ disease or legionellosis in 1976 in Pennsylvania.
❖ Hamburger poisoning in 1992–1993 in the Pacific Northwest of U.S.
❖ Hantavirus pulmonary syndrome (HPS) on Native American
reservations in the Four Corners region in 1993.
❖ Cryptosporidiosis epidemic (a diarrheal disease) in Milwaukee,
Wisconsin in 1993.
❖ West Nile Virus (WNV) epidemic in U.S.
❖ Foodborne disease outbreaks.
❖ Ebola virus in Africa in 1976, 1979, 1994, 1995, 1996, 2001, and
2003.
TYPES OF DISEASES ACCORDING TO
OCCURRENCE
2019 Epidemics in the
Philippines:
❖ Dengue – with 414,532 cases
and 1,546 related deaths from
Jan. 1 to Nov. 30, 2019.
Dengue mosquito
❖ Measels– with 34,950 reported
cases and 477 deaths from
January 1 to May 11
❖ Polio – 8 cases, after 19 years
of having zero cases.
Measles rashes
TYPES OF DISEASES ACCORDING TO
OCCURRENCE
• Pandemic disease – is a disease
that is occurring in epidemic
proportions in many countries
simultaneously, sometimes
worldwide.
TYPES OF DISEASES ACCORDING TO
OCCURRENCE
Pandemic cases:
❖ The 1918 Spanish flu pandemic was the
most devastating pandemic of the 20th
century. It infected 500 million and killed
more than 50 million people worldwide.
Anopheles mosquito
INTERACTIONS AMONG PATHOGENS,
HOSTS, AND ENVIRONMENTS
Factors pertaining to the pathogen:
• Virulence – the measure or degree of
pathogenicity
• Way of entry
• Number of organisms that enter the body
INTERACTIONS AMONG PATHOGENS,
HOSTS, AND ENVIRONMENTS
Factors pertaining to the host:
• The person’s health status
• The person’s nutritional status
• The susceptibility of the host (e.g., age,
lifestyle [behavior], socioeconomic
level, occupation, travel, hygiene,
substance abuse, immune status
[immunizations or previous experience
with the pathogen])
INTERACTIONS AMONG PATHOGENS,
HOSTS, AND ENVIRONMENTS
Factors pertaining to the environment:
• Physical factors such as geographic location, climate, heat,
cold, humidity, and season of the year.
• Availability of appropriate reservoirs, intermediate hosts,
and vectors (discussed later in this chapter)
• Sanitary and housing conditions; adequate waste disposal;
adequate healthcare
• Availability of potable (drinkable) water
CHAIN OF INFECTION
The six components in the chain of
infection are :
1. a pathogen
2. a reservoir of infection
3. a portal of exit
4. a mode of transmission
5. a portal of entry
6. a susceptible host
CHAIN OF INFECTION
Example:
1. pathogen - a cold virus
2. reservoir of infection - Andy has a cold virus.
3. portal of exit - When Andy blows his nose,
cold viruses get onto his hands.
4. mode of transmission - Andy shook hands
with Bob and transferred the virus to Bob’s
hand
5. portal of entry - Bob rubs his nose, the cold
virus is transferred from his hand to the
mucous membranes of his nose.
6. susceptible host - Since Bob had previously
been infected by that particular cold virus
and had developed immunity to it, he is not
susceptible and will not develop a cold.
Figure 1. The six components of the chain of infection
Source: Burton’s Microbiology FTHS 9th ed.page 178
STRATEGIES FOR BREAKING THE
CHAIN OF INFECTION
✔ Practice effective hand hygiene procedures.
✔ Maintain good nutrition and adequate rest and reduce
stress.
✔ Obtain immunizations against common pathogens.
✔ Practice insect and rodent control measures.
✔ Practice proper patient isolation procedures.
✔ Ensure proper decontamination of surfaces and
instruments.
✔ Dispose of infectious waste properly.
✔ Use gloves, gowns, masks, respirators, and other personal
protective equipment, whenever appropriate to do so.
RESERVOIRS OF INFECTION
Incidence
Morbidity Rate (per 1000)
Period Prevalence
Mortality
Mortality rate (per 1000)
Case Fatality rate
References:
• Burton’s Microbiology for the Health Sciences, 9th Edition
• https://www.cdc.gov/flu/pandemic-resources/1918-commemorat
ion/1918-pandemic-history.htm
• https://www.who.int/news-room/fact-sheets/detail/tuberculosis
• https://www.who.int/news-room/fact-sheets/detail/malaria
• https://www.who.int/news-room/q-a-detail/hiv-aids
• https://www.google.com/amp/outbreaknewstoday.com/philippin
es-dengue-outbreak-414k-cases-through-november-2019/amp/
• https://reliefweb.int/report/philippines/unicef-who-philippines-m
easels-outbreak-situation-report-11-27-may-2019
• https://www.who.int/news-room/commentaries/detail/modes-of
-transmission-of-virus-causing-covid-19-implications-for-ipc-preca
ution-recommendations
Other References (for pictures):
• atozreasearch.com
• microbenotes.com
• oneill.law.georgetown.edu
• mayo.edu
• healthcareinamerica.us
• phys.org
• dreamstime.com
• nursingtimes.com
• nhs.uk
• brightinstruments.co.uk
• 123rf.com
• evolution.berkeley.edu
• Economictimes.indiatimes.com
• ft.com